Implementation of automated early warning decision support to detect acute decompensation in the emergency department improves hospital mortality

BMJ Open Quality

article

Christopher Howard¹  Amber B Amspoker¹  Christopher K Morgan¹  Dick Kuo³  Adol Esquivel⁴  Tracey Rosen²  Javad Razjouyan¹  Muhammad A Siddique⁴  James P Herlihy⁴  Aanand D Naik¹ 

[1] Department of Medicine , Baylor College of Medicine;Houston Center for Innovations in Quality, Effectiveness and Safety , Michael E DeBakey VA Medical Center;Department of Emergency Medicine , Baylor College of Medicine;Baylor St Luke’s Medical Center;Management, Policy, and Community Health , University of Texas School of Public Health

关键词: Critical care;    Decision support;    computerised;    Emergency department;   

DOI  :  10.1136/bmjoq-2021-001653

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Early warning alert scores based on clinicaland physiological data have been shown tobe predictive of risk of decompensation inpatients in the emergency department (ED).However, the effect of using these systems toinfluence patient outcomes in the ED hasbeen difficult to ascertain consistently. Part ofthe difficulty in comparing previous studiesare the various systems chosen and faultyimplementation models.The unique coupling of our automatedsystem with the vital sign-based NationalEarly Warning Score score helped to reducedelay and error in the attempt to identify andstabilise decompensating patients. Our studydemonstrates that using an automated decision support surveillance and alert system totrigger alerts for ED patients reduced bothadjusted hospital mortality and hospitallength of stay.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND